[left portion of tri-fold insignia permit and order blank]

         Insignia Permit – Order of the Crown of America

Name Mrs. A. R. Davis
Date Jan. 19th, 1925
__________________________________
Countersigned: Mrs. Robt. G. Hogan
               President-General
_______________________________________________

[center portion of tri-fold insignia permit and order blank]

      Order of the Crown of America
      Founded by Miss Henrietta L. Farnsworth

Date _______________________________19______

To Bailey, Banks & Biddle Company,
            Philadelphia.

Enclosed is ____________ for $25.00

     For the Insignia of the
 Order of the Crown of America

Name  Mrs. Allen Russell Davis

Address  Harriman
              Tenn.

     Engrave my name as follows:

_________________________________

[right portion of tri-fold insignia permit and order blank]

          Insignia Department

Date _______________________19______

Mrs. Robert G. Hogan,
   President General,
      Philadelphia, Penna.

     We have sent by express

   Insignia No. 223 of the
   Order of the Crown of America

Name _____________________________

Address __________________________

    Bailey, Banks & Biddle Company
              Philadelphia.

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Archivist:
Transcription and scan by G. Anne Sloan